Hospitals are lifelines to their communities, providing care 24/7 to every person who walks through the door. Cutting Medicaid, which pays significantly less than delivering the cost of care, will force hospitals to reduce services for all patients. To ensure hospitals can continue to offer care, we must preserve Medicaid funding, including the Federal Medical Assistance Program (FMAP), and avoid work requirements or cuts to directed payment programs.

Medicaid is a critical source of health coverage for nearly 2 million Washingtonians. The proposed cuts will have a devastating impact on our hospitals and communities. Cuts to the system would:

  • Force hospitals to reduce or eliminate services for whole community, not just those on Medicaid.
  • Gut directed payment programs that help Medicaid get closer to covering the true cost of care. Without these payments, Medicaid only covers 50–55% of hospital care costs.
  • Eliminate the $10 million Distressed Hospital Fund, which sustained services in 18 hospitals last year.•Lengthen wait times in emergency departments and stress the capacity of the health care system.

Changes to the Federal Medical Assistance Program (FMAP) will have disastrous impacts for Washington. Reductions in federal Medicaid spending means fewer insured people, increasing the burden on emergency rooms and increases in charity care for hospitals.

Site-neutral payment proponents argue for paying the lowest Medicare rate for all patients across all outpatient settings. However, these cuts do not account for complex care, especially for older and sicker patients, or laws around hospital-based care.

  • Hospital-based clinics face far more stringent regulations than independent physicians’ offices or ambulatory surgery centers (ASCs).
  • Hospitals treat all patients, including those with complex conditions who are often rejected by other outpatient settings. Complex patients go to hospital outpatient departments.
  • Site-neutral payments will force hospitals to cut access to specialty services, impacting both local and rural patients.

The Enhanced Premium Tax Credits are set to expire at the end of 2025. Without action, tens of thousands of Washingtonians will lose access to affordable insurance.

  • These tax credits amount to over $1,300 per year for each individual.
  • Without these credits, premiums will rise by 72%, and 80,000 Washingtonians will forgo coverage, increasing the burden on charity care and hospital finances.